Annex B to

D/SP Pol Pensions/afps 2005/bonus schemes/medical and dental officers

dated 30 March 2006

MEDICAL AND DENTAL OFFICERS (MO/DO) BONUS

Part 1 (To be completed by applicant)

Service Number…………………………………..Rank…………………………………….

Full Name………………………………………………………………………………………

Primary/secondary care bonus applied for [1]………………………………………………

Date of end of short or medium commission[2]……………………………………………….

Date training Return of Service completed …………………………………………………...

Effective date of bonus payment[3] ……………………………………………………………..

5 year return of service expires on[4]…………………………………………………………..

In accordance with the letter of 30 March 2006 (D/SP Pol Pensions/afps 2005/bonus schemes/medical and dental officers), I hereby apply for the MO/DO bonus set out above. I understand that the paying authorities will make the payment on the first possible payday after they receive a Statement of Acceptance with both Parts 1 and 2 completed. I also understand that this payment is made on the basis that I complete five years’ service following receipt of the bonus and that if I do not do so I shall be required to repay the full amount as a lump sum before leaving the Service. However, I understand that there are circumstances in which I shall not be required to repay the bonus if I leave before the end of my five years’ return of service, such as if I am made redundant or medically discharged. If possible, recovery will be made from any Early Departure Payment (EDP) lump sum, where this is paid. Alternative recovery action will be taken in instances where an EDP lump sum is not paid.

Date………………….. Signature ………………………..

On completion the form should be passed to:

Medical Officers

RN – DNCM SO1 Med: Army – Col AMS MCM Div: RAF – DACOS Med Prof Spt

Dental Officers

DDS – AD PPR (advice from: MDG(N) SO1 Dental; Col AMS MCM Div; PMA 20)

Part 2 (To be completed by the relevant medical authority)

The following:

Service Number………………………………………Rank……………………………………..

Full Name………………………………………………………………………………………

qualifies for the MO/DO bonus payment as he/she has agreed to transfer to a medium/full [delete as applicable] commission or has completed 7 years’ service since the earlier bonus payment point. I confirm that the end of commission and training Return of Service dates are correct and that the effective date of bonus payment should be…………………

The pensionable pay in payment on this date should be used in calculating the amount of bonus payable. [Bonus payment details are in paragraph 3 of this letter]

Date …………………………….

Signature ……………………………………..

Appointment …………………………………

Rank/Name……………………………………

On completion, this form should be passed to:

RN -AFPAA (C), RN Pay (Bonus Payment and Return of Service Update)

Army - AFPAA (G) HEO Offrs Pay Div (Bonus Payment)

- AMS MCM Div (2)-1 for the Return of Service update and copy for P/File: 1 to applicant

- AFPAA (G) Offrs Pay File.

RAF - AFPAA JPAC, Glasgow (Bonus Payment)

- PMA 20 (RAF) for the officer’s dossier

- PMA 8 (RAF) For the Return of Service update on JPA

[1] Bonus details are set out in para 3 of covering letter

[2] This should be the date the commission was originally scheduled to end even if the individual has now moved onto a new commission.

[3] Effective date of payment is at end of commission or end of training Return of Service whichever is the later.

[4] Bonus Return of Service expires 5 years from the effective date of bonus payment.